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Organization
PRIME PSYCH VA, LLC
Active
Organization
PRIME PSYCH VA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FRANK ROBERT ROSE PSYD (LICENSED CLINICAL PSYCHOLOGIST)
(804) 695-6633
Entity
Organization
Contact information
Practice address
7751 SQUIRREL LEVEL RD, NORTH DINWIDDIE, VA 23803-7637
(804) 695-6633
(855) 978-2324
Mailing address
1050 TEMPLE AVE # 524, COLONIAL HEIGHTS, VA 23834-2981
(804) 695-6633
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0810005750
VA LCP ID#
VA
01
—
1043738206
NPI TYPE 1
—
Enumeration date
09/08/2021
Last updated
01/21/2026
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